Characterising treatment outcomes of patients achieving quarterly aflibercept dosing for neovascular age-related macular degeneration: real-world clinical outcomes from a large tertiary care centre

Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study o...

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Bibliographic Details
Published in:	Eye (London) Vol. 37; no. 4; pp. 779 - 784
Main Authors:	Fu, Dun Jack, Hanumunthadu, Daren, Keenan, Tiarnan D. L., Wagner, Siegfried, Balsakas, Konstantinos, Keane, Pearse A., Patel, Praveen J.
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 01-03-2023 Nature Publishing Group
Subjects:	692/53/2423 692/699/3161/1626 Acuity Age Angiogenesis Inhibitors - therapeutic use Dosage Electronic medical records Eye Female Humans Infant Injection Intravitreal Injections Laboratory Medicine Macular degeneration Macular Degeneration - drug therapy Male Medicine Medicine & Public Health Ophthalmology Patients Pharmaceutical Sciences/Technology Receptors, Vascular Endothelial Growth Factor Recombinant Fusion Proteins - therapeutic use Retrospective Studies Surgery Surgical Oncology Tertiary Care Centers Treatment Outcome Vascular endothelial growth factor Visual acuity Wet Macular Degeneration - diagnosis Wet Macular Degeneration - drug therapy
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Summary:	Background and objective To evaluate the proportion of patients achieving a 12-week (q12) aflibercept dosing interval in patients with neovascular age-related macular degeneration (nAMD). Patients and methods Retrospective, comparative, non-randomised electronic medical record (EMR) database study of the Moorfields database of treatment-naïve nAMD eyes. Extraction criteria included at least 7 aflibercept injections in first year of treatment, AMD in the diagnosis field of EMR, and minimum of 1 year follow-up data. Results There were 2416 eyes of 2163 patients started on anti-vascular endothelial growth factor (anti-VEGF) between 01-11-2013 & 14-02-2020 who had received at least 7 aflibercept intravitreal injections (electronic database accessed March 2021). Of these, 1674 (68%) eyes of 1537 patients had at least one q12 dosing interval (>=84 and < =98 days between injections) during the first 2 years of treatment. This included 926 (61.8%) female patients and 856 (right eyes age at 1st injection), 936 (62.4%) Caucasian, and 32 (2.1%) Afro-Caribbean patients. The median time to the first q12 injection (95% confidence interval) was 1.76 years (1.70–1.86) with mean (±SD) of 11.8 (±6.0) injections. Visual acuity (ETDRS letters) of the eyes without q12 injection and eyes with a q12 injection was 57.9 ± 14.7 and 56.7 ± 14.8 respectively at baseline, 61.4 ± 18.1 and 63.0 ± 15.9 respectively at 12 months and 61.2 ± 20.1 and 61.1 ± 17.8 respectively at 24 months. Conclusion 68% of eyes were able to achieve a q12 injection dose within the first 2 years of treatment. Eyes achieving a q12 injection in the first 2 years achieved a similar visual acuity outcome at both 1 and 2-year follow-up to those unable to do so, with a fewer number of total injections.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Commentary-3 content type line 23
ISSN:	0950-222X 1476-5454
DOI:	10.1038/s41433-022-02220-1